University of Nairobi Journal Systems
Not a member yet
1034 research outputs found
Sort by
HYPODONTIA OF PERMANENT TEETH IN A KENYAN POPULATION
No full textObjective: To assess the cnxurrence of hypodontia (except 3rd molars) in a population oforthodontic patients.Design: A retrospective case study.Setting: Private orthodontic practice in Nairobi.Patients: Six hundred and fifteen orthodontic patients aged eight to fifteen years.Results: Hypodontia occurred in 39 children (6.3%). The missing teeth were observed in 24males (7.2%) and 15 females (5.3%). Of thechildren with hypodontia, about 80% lacked oneor two teeth, 54 % had hypodontia involving anterior teeth, 18% lacked single posterior teethand 8% had two or more teeth missing in the same quadrant. The highest recorded numberof missing teeth in any one individual was seven. The most frequently missing teeth weremandibular 2nd premolars (30%), maxillary 2nd premolars (24%) and maxillary lateralincisors (22%) in that order.Conclusions: Our data for hypodontia were within the wide range reported in the literature.The finding of patients with hypodontia involving the anterior teeth and others missing morethan two teeth in the same quadrant was an indication of a great need for orthodontictreatment. The present findings reiterate the neeed for a thorough radiographic evaluationof patients prior to removal of permanent teeth for orthodontic reasons
PREVALENCE OF HIV/AIDS AND PSYCHIATRIC DISORDERS AND THEIR RELATED RISK FACTORS AMONG ADULTS IN EPWORTH, ZIMBAMBWE
No full textABSTRACTObjectives: To examine the prevalence of HIV infection, neuropsychiatric disorders,psychiatric symptoms/signs, alcohol use/misuse, CD4 cell counts and risk factors in adultpatients.Design: Cross-sectional study.Setting: Epworth, which is about 15km on the southeastern part of Harare, Zimbabwe.Subjects: Two hundred subjects were included in the study out of which six wereexcluded beacause of HIV-1 indeterminate results.Materials and Methods: A convenience sample of 200 subjects recruited in a crosssectionalstudy in Epworth, Zimbabwe. Six subjects had indeterminate HIV-I antibodyresults and were excluded from the study. The remaining 194 subjects of whom 101(52.1%) knew about their sero-status and were consecutively recruited, whereas, 93(47.9%) did not know about their sero-status and were recruited by a systematic randomsampling method (1-in-3). They were then interviewed about neuropsychiatric disordersusing BPRS, MADRS, AUDIT and MINI Mental State Test, including the risk factorsrelated to HIV infection. After ELISA tests' results, the two groups were combinedand then categorised into HIV positive (n=115) and HlV negative (n=79) subjects.Main outcome measures: Prevalence, neuropsychiatric disorders, increased CD4 cellcounts and risk factors associated with HIV infection.Results: The findings were that the overall point prevalence of the HIV infection was59.3% (115/194). Comparative analyses between seropositive and seronegative HIV/AIDSsubjects showed: over two thirds (71.3%) of the HIV positive subjects suffered frompsychiatric disorders, more than those with HIV negative 44.3% (OR= 3.12, 95% Cl=1.64-5.95, P=0.0002), and subjects aged 35 years and less were mostly HIV seronegatives(n= 77.2%, OR= 2.34, 95% CI= 1.18-4.75, P=0.014). The overall prevalence of alcoholuse/misuse was 41(21.1%), with higher prevalence rate among HIV positive subjects,28 (24.3%) than those who were HIV negative, 13 (16.5%). The commonest psychiatricsymptoms/signs (P<0.05) were emotional withdrawal, depressed mood, suspiciousness,apparent sadness, reduced sleep and suicidal thoughts (specially among women).Conclusion: There is very high point prevalence of HIV/AIDS and psychiatric disorders,including a moderate prevalence rate of alcohol use/misuse in this less affluentcommunity that warranted intervention
NUTRITIONAL RICKETS IN YOUNG NIGERIAN CHJLDREN IN THE SAHEL SAVANNA
No full textObjectives: To determine the prevalence of clinical and biochemical rickets in an under-fiveout-patient population, relate the prevalence of biochemical ricliets (BR) to the socioculturalcharacteristics of families and determine the response af nutritional rickets tovitamin D therapy.Design: Prospective cross-sectional and retrospective case-series SI lrveys.Setting: Paediatric general out-patient and consultant clinics.Subjects: One hundred and ninety eight out-patients and twenty two patients aged >1 to 60months treated for nutritional rickets.Interventions: Clinical examination, interview with mothersand dete~ mination of biochemicalabnormalities of under-fives and management of patients with riclrets using stosstherapy.Main outcome measures: Prevalence of BR and response to stosstherapy.Results: Eight (4%) patients in the survey had clinical and biocbernic al rickets while 33 (17%)had biochemical rickets only; 92 (47%) other patients had isolate11 hypocalcaemia and/orhypophosphataemia. The prevalence of BR was higher in males (p d).05), and increased withage (p <0.001). The prevalence was lower in families who were indigel lous to the area (p <0.05),children of Moslem families (p <0.05) and children whose mothers w ere full-time housewives,unskilled or traders (p <0.01), and who lacked any formal western ed~ lcation (p = 0.157). Threeof the seven evaluable patients who received stosstherapy responde 3 late.Conclusion: The results support the hypothesis that deficiency 01. reduced availability ofdietary calcium may be of at least equal importance with vitamin D d eficiency in the aetiologyof nutritional rickets in the Sahel savanna
COMPARISON BETWEEN SONOGRAPHIC AND PLAIN RADIOGRAPHY IN THE DIAGNOSIS OF SMALL BOWEL OBSTRUCTION AT MULAGO HOSPITAL, UGANDA
No full textABSTRACTObjective: To evaluate the role of sonography compared to plain radiography in thediagnosis of patients with suspected small bowel obstruction as well as to determinetheir specificity, sensitivity and accuracy in the Ugandan setting.Design: Prospective comparative study.Setting: Mulago Hospital, Uganda’s main referal Hospital and Makerere UniversityMedical School.Subjects: Seventy patients with suspected small bowel obstruction (SBO) were evaluatedat Mulago Hospital between December 1998 and January 2000, 42 patients were malesand 28 females. Patients were aged three days to two years and had a clinical suspicionof SBO.Results: Of the 70 patients, 55 were confirmed to have had SBO. Four had ileus and11 had no SBO. Sixty four per cent were managed surgically while 36% were managedconservatively. Sonography made a diagnosis of SBO in 92.7% and detected strangulationin 71% of patients. Plain radiography made a diagnosis in 85.5% of patients and didnot detect strangulation. Specificity was 100% for both, sensitivity 93%, PPV 100%,NPV 73% for sonography. Sensitivity was 85%, PPV 100%, NPV 58% for plainradiography.Main outcome measures: The accuracy of sonography was 93% as compared to 87%for plain radiography. The level of obstruction was correctly predicted in 81% bysonography and 64% with plain radiography.Conclusion: It was concluded that sonography is as accurate, specific and sensitive asplain radiography in the diagnosis of SBO as well as determining the level of obstructionin a Ugandan setting. Sonography was found to be more accurate at determining thecause of obstruction and detecting strangulation. It is recommended that sonographyshould be the initial imaging modality for patients presenting with suspected SBO andplain radiography should only be used as a complimentary investigation
IMPACT OF CATTLE KEEPING ON HUMAN BITING RATE OF ANOPHELINE MOSQUITOES AND MALARIA TRANSMISSION AROUND ZIWAY, ETHIOPIA
No full textObjective: To assess the impact of livestock keeping on the human biting rate (HBR)of anopheline mosquitoes and malaria transmission around Ziway in the middle courseof the Ethiopian Rift Valley.Design: As a passive experiment, man landing captures were done in homesteads withmixed dwelling, separate cattle shed and without livestock; and as an active experiment,captures were in experimental tukuls (huts) of cattle, goats, and without livestock.Parasite and spleen rates of children were compared among those residents undervariable living conditions mentioned for passive experiment.Subjects: For entomological study, human-baits were used for man-landing captures ofmosquitoes. Study subjects for parasitological and clinical studies were children below10 years old.Main outcome measures: Human-biting rate (HBR) of anopheline mosquitoes; and theparasite and spleen rates of the study subjects in different living conditions.Results: In the passive experiment, the mean HBR of Anopheles arabiensis in mixeddwelling, separate cattle shed and without livestock was 8.45, 4.64 and 5.97, respectively.Similarly, the HBR of An. pharoensis was 2.88, 1.79 and 1.61, respectively. In the activeexperiment, the mean HBR of An. arabiensis in tukuls with cattle, goats, and withoutlivestock was 3.50, 3.38 and 1.43 respectively; while that of An. pharoensis was 0.37,0.70 and 0.55 respectively. Parasitologically, mean parasite rates of 26.67%, 15.05% and23.85% were, respectively, recorded from children living under the above conditionsstated for passive experiment. Similarly, the mean spleen rates of 50.0%, 26.9%, and47.37% were recorded, respectively.Conclusion: These observations in the present study indicate that the presence of cattlein homesteads tends to increase the man biting rate of An. arabiensis, althoughdifferences in the mean HBR of vector mosquitoes were not statistically significant forall groups. In contrast, cattle keeping in separate cattle sheds outside of the humandwellings tends to reduce the man biting rate of An. arabiensis and malaria transmissionin the study area
OPTIMISATION OF PATIENT PROTECTION AND IMAGE QUALITY IN DIAGNOSTIC RADIOLOGY
No full textObjective: To determine the examination frequencies, quality of radiographic images and the entrance surface dose (ESD) in patients undergoing general radiographic examinations.Design: Prospective study on the device performance, film reject rate, patient dose, and image quality during the use of standard and fast speed film screen combination.Setting: Radiology Department of Kenyatta National Hospital, a referral, teaching and research hospital in Kenya.Subjects: A total of 837 adult and 229 paediatric patients undergoing diagnostic examinations were assessed for patient dose and image quality.Interventions: The X-ray tube output measurements and X-ray exposure parameters were determined. The patients ESD on standard 200 and fast 400 speed film screen combination was determined. The radiographic image quality was assessed.Main outcome measures: The findings were compared with the international diagnostic reference levels (DRL’s) for determination of dose optimisation in diagnostic radiography.Results: The relative frequency of examination was 80% and 20% for adults and paediatric patients respectively. The image quality improvement by 13% was achievedand patient dose reduction range of 31% to 77%.Conclusions: The patient dose reduction and image quality was achieved through a quantitative quality control (QC) assessment of processes involved in producing radiographs. The study leads to the introduction of the concept of plan- do-check-act on QC results and optimise with a view of patient dose reduction. The department appreciated the value of a quality assurance (QA) programme and continues to collectdata for establishment of DRL’s
PULMONARY FUNCTIONS IN ARC-WELDERS IN ILE-IFE, NIGERIA
No full textObjective: To investigate the occupational effects of Arc-welding on small scale welders inModakeke, Ik-Ife, Nigeria.Design: A community-based, cross-sectional study.Setting: A semi-urban area Modakeke, Ile-Ife, Nigeria.Populatian: A semi-urban area with a population of about 300,000 (three hundred thousand).Shrdypopulation: Forty four Arc-welders in Modakeke, Ile-Ife and fifty age andsex-matchedcontrols working in the Maintenance Department of Obaferni Awolowo University, Ile-Ife,Nigeria.Intervention: Structured questionnaires adapted from the Medical Research Council, UKrespiratory questionnaire with some modifications were administered to all subjects andcontrols. Physical examination and lung function tests were also carried out on all subjectsand controls.Main outcome measures: Occupational-related symptoms of welders and controls werecompared. Ventilatory function of welders and controls were also compared using theStudent's %'-test. Chi-square was adopted to test the strength of relationship betweensmoking and lung function abnormalities.Results: The most frequent symptomsfound among the subjects wereeyeirritation (95.43%),rhinitis (50.09%) and skin irritation (43.19%). The arc-welders were found to havecharacteristically tower lung function parameters than controls (p<0.05). Ten (22.7 %)of thesubjects had obstructive lung disease compared to four (8%) of the controls; while 18(40.9%) of the subjects had restrictive lung disease. Their lung abnormalities had norelationship to their smoking history.Conclusion: Workers exposed to arc-welding are at risk of occupational-related symptomsand chronic lung disease. Adoption of protective devices and monitoring of welders'breathing zones for toxic levels of gases and fumes are necessary to reduce the risk associatedwith arc-welding
PERSISTENT HEPATITIS A INFECTION: CASE REPORT
No full textHepatitis A viral infection resolves completely within six months in all patientsinfected. The case presented is a rare one that took fifteen months to resolve from hepatitis A viral infection
CONGENITAL MALFORMATIONS IN MICE INDUCED BY ADDICTION TO ALCOHOL AND COCAINE
No full textObjective: To study the teratogenic effect of either alcohol alone, cocaine alone, or a combination of both alcohol and cocaine on mice foetuses.Design: Eighty pregnant mice were divided into four equal groups. In the first (alcohol) group, the pregnant females were given absolute ethanol at 2.5gm/100 gm twice daily by oro-gastric incubation. In the second (cocaine) group, the pregnant females received cocaine hydrochloride at 20 mg/ 100 gm daily by intraperitoneal injection. In the third(combined) group, the pregnant females received alcohol at 2.5gm/100 gm twice daily and cocaine hydrochloride at 20 mg/100 gm daily. In all groups the treatment started from the 6th day to the 15th day of gestation. The fourth group is the control.Settings: Department of Anatomy, College of Medicine, King Faisal University, Dammam, Saudi Arabia and Department of Anatomy, College of Medicine, Al-Azhar University, Cairo, Egypt.Intervention: The pregnant mice were sacrificed at the 20th day of gestation (one day before term). The uterine contents were evaluated and the number of dead and live foetuses was determined as well as the number of resorption. The living foetuses were examined for soft tissue anomalies.Subjects: Eighty pregnant mice.Results: This study revealed a significant increase in the number of dead foetuses and foetal growth parameters showed a significant decrease in the combined group. This group showed significant increase in anomalies of the head as hydrocephaly and complete cleft palate, of the kidney as bilateral secondary hydronephrosis and ectopic kidney, of the limbs, and of the tail as kinked tail. Both alcohol and cocaine groups alone showedsignificant increase in some of the anomalies of the head while in the alcohol group there was unilateral hydronephrosis.Conclusion: This study indicates that the combined administration of alcohol and cocaine has a more teratogenic effect than either alcohol or cocaine alone
COLLAGEN Ial AND VITAMIN D RECEPTOR GENE POL3MORPHISMS IN SOUTH AFRICAN WHITES, BLACKS AND INDIANS
No full textObjective: To determine whether polymorphic differences exist between black, white andIndian South Africans in genes associated with bone miner id density and osteoporosis.Design: Genes selected were the vitamin D receptor (Apa I and Taq I polymorpbisms) andcollagen (Sp I transcription factor polymorphism) using standard molecular biologytechniques.Setting: Department of Chemical Pathology, Nelson RMande aSchool of Mediiine,Universityof Natal, Durban, South Africa.Subjects: Healthy male and female blood donors living in tt e Durban metropolitan region,South Africa. The group comprised black Africans (n=264) white Caucasians (n=247) andAsians of Indian origin (n=194).Results: Nosignificant differences in genotypes were seen bet ween white and Indian subjects.Blacks had a significantly higher frequency of the TT Taq I genotype and a significantlylower frequency of the Ss Sp 1 genotype. No ss genotype was detected in blacks.Conclusion: The very Low frequency of the collagen Sp I s allele and higher frequency of theVDR T allele in blacks may be associated with the lower ir cidence of osteoporosis in thisethnic group